Pulmonology Coding Alert

When G codes are off limits, consider coding for inhalation treatments and chest manipulation.

If you are like many practices nationwide, you face pulmonary rehabilitation reimbursement challenges that may even restrict whether you offer this service. Here's the skinny on what you can report in the absence of a national coverage determination (NCD):

Good news: If you can't report G codes because your local Medicare Administrative Contractor (MAC) doesn't cover PR services or you aren't a contracted provider, opt for CPT Codes to report whatever took place on that particular day, points out Carol Pohlig, BSN, RN, CPC, senior coding and education specialist at the University of Pennsylvania department of medicine in Philadelphia.

Procedures that your pulmonologist might have performed include:

• 94010 -- Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation

• 94060 -- Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration

• 94070 -- Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (e.g., antigen[s], cold air, methacholine)

• 94620 -- Pulmonary stress testing; simple (e.g., 6-minute walk test, prolonged exercise test for bronchospasm with pre- and post-spirometry and oximetry)

• 94664 -- Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device

• 94640 -- Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes (e.g., with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing [IPPB] device

• 94667 -- Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation.